Provider Demographics
NPI:1144586710
Name:BROWN, ERIC WILLIAM (LCPC, LADC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:WILLIAM
Last Name:BROWN
Suffix:
Gender:M
Credentials:LCPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 PARK RD
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-3142
Mailing Address - Country:US
Mailing Address - Phone:207-899-5601
Mailing Address - Fax:
Practice Address - Street 1:33 TWIN PINES RD
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:ME
Practice Address - Zip Code:04071-6740
Practice Address - Country:US
Practice Address - Phone:207-899-5601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-08
Last Update Date:2012-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC3721101YA0400X
MECC3609101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)